An MUS gives a cure rate of over 93% at a median follow-up of 54 months. A significant decline in UDI-6 and IIQ-7 is evident after surgery. Sexual function, as measured by the FSFI, was not significantly affected.

Female urethral defects are usually complex. Congenital causes are associated with severe incontinence. Repair of such defects is challenging, yet 1-stage reconstruction is feasible and potentially successful.

INTRODUCTION AND OBJECTIVE: Gynaecological and obstetric surgeries are not uncommon causes of iatrogenic injury of the urinary tract. Herein, we retrospectively report our experience with these injuries over the last 18 years. METHODS: Between 1985 and 2003, 120 women with a mean age of 34.2 :!: 13.7 years were included into this study. The types of injury were vesicovaginal fistula in 90 cases, ureterovaginal fistula in 14, ureteric ligation in 13, vesicouterine fistula in 2 and ureterouterine fistula in one. Definitive repair of such injuries either fistulae or ureteric strictures was performed in all cases except for 10 cases with recurrent vesicovaginal fistulae , who were treated by augmentation cystoplasty or urinary diversion. All patients were evaluated for the time and type of surgical intervention, early and late postoperative complications including failed primary repair.RESULTS: Out of the 80 cases of vesicovaginal fistulae treated by definitive repair, 12 showed recurrence of the fistula (13.3% ). Early ureteric deligation and early or delayed ureteroneocystostomy or ureteric replacement were successful in all cases with ureteric injury.CONCLUSIONS: Careful attention of the gynaecologists and obstetricians to the anatomy of the urinary tract is mandatory to avoid its iatrogenic injury. Endourologic means were successful in making first aid management of some of these injuries. Early exploration is indicated in cases of ureteric obstruction, presenting early after trauma. Augmentation cystoplasty, urinary diversion or ileal replacement is indicated only in few cases.

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